Feyz Medical Sciences Journal
Year:2001 | Volume:4 | Issue:16|Papers Count:21

History and Objectives: Dietary soluble fiber has beneficial effects on serum glucose and lipid levels. Sugar beet is one of the dietary soluble fibers. Contradictory results have been associated with the effect of its consumption on serum glucose and lipid levels. Therefore, the present study was performed to assess their effect on type II diabetic patients admitted to Diabetic Clinic in Kashan' in 1997-98. Materials and Methods: A cross-over, sequential and single blind clinical trial was carried out on 30 type II diabetic patients with FBS>7.8mmol/L and HbA1C 5-9% who were treated with 2 tablets of Glibenclamide per day. Sugar fiber beet was refined, dried, ground and packed into 10 gram samples. The individuals were randomly divided into two groups; one receiving 20 grams of sugar beet fiber, blended with yogurt at lunch and dinner for 4 weeks, while the other group receiving 20 grams of starch powder instead. The individuals in each group had another 4 weeks of cross-over followed by 2 weeks of wash out. Blood samples were taken for FBS and serum lipids at the begining of the study and 5 additional samples at 2 week intervals. Paired t-test and t-test were used for statistical analysis. Results: Consumption of beet sugar fiber caused a reduction of 33% (P<0.001), 13% (P<0.01), 11% (P< 0.05), 30% (P<0.02) and 15% (P<0.05) in FBS, total cholestrol, LDL-C triglyceride and total Cholestrol/HDL-C ratio respectively. Furthermore, the results indicated that sugar beet fiber consumption did not have any statistically significant effect of HDL-C levels during the period of study. Conclusions: Consumption of sugar beet fiber, as a glucose and lipid lowering agent is recommended for type II diabetic patients.      

History and Objectives: Communication skills between doctors and patients are very important in the diagnosis, treatment, and prevention of diseases. In order to determine the attitude and communication skills of doctors towards their patients the present study was carried out in Shiraz in 1998. Communication skills were assessed on the basis of patients and researchers interpretation of such skills and attitude of doctors towards training and application of communicational skills of doctors with their patients. Materials and Methods: A descriptive study was carried out on doctors. Five percent of doctors were selected randomly. From every private clinic, 3-5 patients were selected. Communication skills were assessed on the basis of six typical behavior of doctors from point of view of patients and researchers. Attitudes of doctors were assessed by 19 Licret. Communication skills were classified as poor, average and good and attitudes were classified as positive and negative. Results: Patients reported 12% and 60% of doctors poor and good communicational skills. With increasing age, education, patient's expectation of communicational skills increased. Female doctors and general practitioners displayed better communicational skills compare to the specialists. Training and application of communicational skills were states as useful among 65% of doctors; this attitude was similar among male and female doctors regardless of their specialty. However, older doctors and those with greater number of working years had put greater emphasis  on the training and its application. Conclusions: Communication skills between doctors and their patients are low. Due to its importance, it is subjected that continuing training should be conducted on regular basis.      

History and Objectives: The regulation of glucose concentration in blood is one of the complex phenomenon which is effected by several h017nonal and neuronal systems. In addition to hormones, neurotransmitters like GABA also play a role in the homeostasis of blood glucose. Materials and Methods: In these experimental study male albino mice weighting 20-25 grams were used. The effect of GABA agonist and antagonist on the glucose concentration was determined. The effect of various doses of drug on blood glucose was assessed. T-student test and one way variance analysis was carried out on two groups. Results: The injection of bicucullinr and picrotoxin induce a significant increase glucose concentration in two groups (p <0.05). Intraperitoneal injection of muscimol at 1, 2 and 4mg/kg not only did not reduce blood glucose in the experimental group but that 6mglkg augment blood glucose levels to significant levies (p <0. 05). Conclusions: GABA -A through increase plasma insulin and reduced glucagon and somatostatine decreases blood glucose levels. Due to the complexity of GABA-A receptors further work is needed to understand the mechanism.      

History and Objectives: Due to the importance of correction corneal astigmatism in improvement of vision and reported various techniques, the present study was carried out to determine the effect of radial keratotomy on patients with astigmatism on patients referred to the Matini Hospital in 1996-1997. Materials and Methods: A quazi-experimental study was carried out in order to compare the vision of 34 patients (60 eyes) before and after the operation who were complaining from contact lens and eyeglass usage. Personal records, vision acuity with and without correction, type and extent of astigmatism were recorded. The criteria for operation were diopter of 1.25 and the best value for correction was set at 40.20. Radial keratotomay was carried out using 7mm Ophcal Zone on the basis of Lindstrom nomogram. Patients were followed for six month after the operation; and the effect of surgery was assessed on vision, the extent and type of astigmatism, and probable surgical side effects were recorded. T-test and Mc Nemor statistical test were carried out in order to determine the effect of keratotmy. Results: From 34 patients (9 male, 25 female; mean age 30±.5.2) 98.3% of patients had corrected vision by eye-glasses and contact lens use of more than 40.20. After surgery 82.5% of patients retained vision of 40.20. Mean esfer with astigmatism before the operation was 3.8±2.05 diaopter of myopia and after operation was 2±0.8. In 21.6% of patients side effects such as microperfusion and epithelial abnormality was observed. Conclusions: Surgical operation in order to correct astigmatism by radial keratotomy on the basis of Lindstrom nomogram is very effective and has minimal side effects. The results in the reduction of astigmatism and improvement of vision is such that it is recommended for corneal vision problems.      

History and Objectives: Since no previous mycological study has been conducted in Kashan's schools, the present study was designed in order to determine the prevalence of fungal infection and their causes in the region. Materials and Methods: 3450 students were examined and suspected skin lesions were collected carefully and samples were collected, cultured and cleared by KOH. Results: From. 426 cases with probable infection, 385 cases (11.16%) were showed to be infected (100 males, 285 females). Pityrosporosis (207), trichomycosis axillaris (135), tinea versicolor (17), and otomycosis (1) were the most frequent type of mycoses. The cutaneous mycoses included Tinea capitis (3) and onychomycosis (2). Conclusions: On the basis of the present study, it is suggested that future descriptive as well as analytical studies be cindacted in these groups of subjects.      

History and Objectives: Lead poisoning is a major public hazaed. Determination of lead in blood is expensive and time-consuming in recent leads poisoning exposures. Materials and Methods: We studied the relation between the concentration of lead in blood and erythrocyte protoporphyrin in blood in the 857 subjects. Blood lead concentration was measured by atomic absorption spectrometry. Cutoff points were 0.68 micromol/L. Erythrocyte protoporphyrin was determined by spectroflurometric procedure, cutoff point was 0.53 micromol/L. We calculated the sensitivity, specificity, the positive predictive value, the negative predictive value and correlation for erythrocyte protoporphyrin and atomic absorption method. Results: Sensitivity, specificity, the positive predictive value and the negative predictive value for erythrocyte protoporphyrin method and atomic absorption method were 98%, 97%, 97%, 98% and 74%, 68%, 69% and 72% respectively. Conclusions: The present study describes application of a simple, sensitive and economical detection method of lead poisoning. The data indicate that the erythrocyte protoporphyrin value obtained by this method could be used as a screening test for lead poisoning.      

History and Objectives: Depression is a debilitating factor in life. Its frequency is estimated to be around 15-20%. It's prevalence among students groups were reported from] 0 to 64%. Depression may lead to suicide, drug dependence, low self confidence and may lead to low school performance among students and it will have adverse effect directly and indirectly on the society as a whole. The present study was carried out in order to determine the prevalence of depression among university students in Kashan in 1996-1997. Materials and Methods: A descriptive study was carried out on 310 subjects. Individuals were selected on random basis. A short version of Beck standard questionnaire was given to each student. Personal records were collected. Results: From 307 individuals, the prevalence was 35.8%. Depression was most prevalent among health and hygiene students (42.3%) and the medical students had the lowest prevalence (28.4%). Depression was not related to gender, and residency of students. Conclusions: Due to relative high prevalence of depression among students, preventive measures ought to be designed in order to reduce stressful situations.      

History and Objectives: Nocturnal hypoxemia in patients with chronic obstructive pulmonary disease (COPD) is a frequent side effect. Because there is frequent occurrence of pulmonery hypertension and cardiac al7hythmia in these patients, it is important to diagnose and treat nocturnal hypoxemia. In this research we investigated the changes of hypertension and hypoxemia during day and night in patients with COPD who were referred to the internal medicine ward of Shahid Beheshti Hospital in 1999. Materials and Methods: A descriptive study was conducted on 68 patients with COPD. Arterial blood gas measurement was performed from radial artery in sapine position in duplicates in the day and at night. Mean PaO2 and PaCO2 during day and night and changes of mean PaO2 in different levels of hypercapnia were determined. Results: Night time decrease in PaO2 and SaO2 and increase in PaC O2 was significant compare to the day time values (day: PaO2 = 62.2±13.9 mmHg, night: 57.6±12.2.p<0.00l, day: SaO2 =88±7.5%, night: Sa O2 = 66±9%, p<0.001, day: PaCO2 = 46±7.5 mmHg, night: PaCO2 = 47.6±8 mmHg, p <0.001). The decrease in PaO2 during night in patients with PaO2<60 mmHg wasmore than inpatients with PaO2>60 mmHg (7.4±12. 7mmHg, 1.4±7.6mmHg, respectively, p=0.019). In patients with PaCO2 <45mmHg and PaCO2>45 mmHg, Pa O2 in the day and night were 66.8±12.7 mmHg, 62.1±10.4 mmHg, 57.7±13.8 mmHg, 53.1±12.4 mmHg respectively. The amount of changes in both groups was 6.97% and 7.85% respectively. Conclusions: Hypoxemia and hypercapnia are increased during night in patients with COPD. The amount decrease in nocturnal hypoxemia depends on its amount in the day. The amount of decrease in hypoxemia depends on the degree of hypercapnia. In patients with COPD, who has hypercapnia and hypoxemia, O2 delivery in the night and the improvement of hypoxemia is very important      

History and Objectives: Due to importance of urinary tract infections (UTI), and its complications, the present study was performed on patients referred to the Central Pathobiology Laboratory in Kashan in the second half of 1999 to evaluate the urine exam and culture. Materials and Methods: A descriptive study was carried onpatients with urinary tract infection referring to Central Laboratory. Urine samples were collected from mead stream urine (MSU). The samples were cultured on blood agar paltes (BAP) and eosine methylene blue (EMB) agar in 37°C for 24 hours and after colony counting, bacterial colonies were diagnosed by culturing on differential biochemical media. Urine examinations were performed macroscopically and microscopically and the data were presented using descriptive statistical analysis. Results: of 505 patients, 127 patients (25.1%) had positive urine culture of which 90.6% and 9.4% were women and men respectively. E. coli (77.2%), Coagulase negative staphylococci (17.3%) proteus (3.2%), Klesiella (1.6%) and pseudomonas (0.8%) were the most prevalent microbial infection. From 127 positive culture tests, 63.8% had positive bacteria on direct smear examination, 55.1% had PMN and 53% had nitrate reduction positive test. Forty one (52%) patients were positive for bacteria, PMN cells and nitrate reduction positive in their urine. Conclusions: Urine analysis cannot detect the urinary tract infections without culturin. Further analytical study is recommended to determine the importance of urine analysis in detecting the urinary tract infections.      

History and Objectives: Due to the prevalence and importance of diagnosis of fungi in Iran and considering the difficulties and the economic cost of providing different stains and culture media, the present study was undertaken. Materials and Methods: A descriptive study on 10 strains of fungi including opportunistic, dermatophytes and yeast were performed. The effects of culture media and staining techniques were studied on the modified water agar, Saboraud's agar, mycobiotic agar, corn meal agar, nutrient agar with methods of Riddel, microslide, hole making, Scotch tape, Gram, Giemsa, wright Giemsa, PAS, Wright, Lactophenole catton blue, Kinyoun's acid fast, methylene blue, Calcofour white, Congo red and Acridine orange. Results: The present study showed that Sepedonium, Trichotheclum, Microsporomgypseum, Candida albicans, Aspergillus fungi were etiologic agents in the modified water agar and in the microslide, epidermophyton fluccosum modified water agar and Trichophyton mentagrophyton in Riddel method was grown better than other procedures. Conclusions: Due to the results of the present study, both Gram and Giemsa stains were better than other staining techniques and water agar is selective medium for better identification of  fungi.      

History and Objectives: Urinary tract infection is one of the most prevalent among children. Its diagnosis and treatment is very important. Urine analysis and leukocyte deterction is the corner stone on the deterction of urinary tract infection. The present study was carried out to find a relationship between the number of urinary leukocytes and the extent of infection (high temperature, high ESR) in Shahid Beheshti Hospital in 1994-1995. Materials and Methods: The present study was carried out on existing data from hospital records on patients with diagnosis of urinary tract infection. Personal records, leukocyte count, ESR body temperature was recorded. Results: From 117 children (105 girls, 12 boys), 42% were in the age group of 1-5 years, 30% were under the age of one and 28% were above the age of five. There was no correlation between leukocyte count and ESR and leukocyte count and body temperature among patients with urinary tract infection. Conclusions: Urinary tract infection is usually is accompanied with elevated leukocyte count, high ESR value and augmented body temperature. Since urine analysis with low leukocyte count does not require extensive treatment, and since ESR and urine culture is more informative in the assessment of the disease, further research is needed to required.      

History and Objectives: Hypertension during spinal anesthesia is a common complication and can cause sever morbidity and mortality. Due to repeated reports positive preventive effect of hemaccel and in order to compare the effect of colloidal and crystalloid intra venus infusion of hemaccel and Ringer solution, and on prevention of hypotension during spinal anesthesia, the present study was carried out on patients referred to the Fatemieh Hospital in the city of Hamedan. Materials and Methods: A clinical trial was carried out on 100 patients who were schedualed for post partum tuballigation with spinal anesthesia. Before anesthesia, heart beet, and arterial blood pressure were recorded for all patients. All patients received spinal anesthesia and were randomly divided into two control and case groups. Hemaccel and Ringer (15mL/Kg) were administred by venous perfusion to case and control groups respectively. At 1, 5, 10, 15, 30 minutes intervals changes in heart beet and arterial blood pressure and further infusion of Ringer solution and infusion of ephedrine was recorded. Results: 100 patients were equally divided into two groups and were matched for age and duration of surgery. Reduction in heart beat was less in the case group compare to the control group and arterial blood pressure was] 0] and 87 in the case and control group respectively. Need for Ringer solution was 8% and 80% in the case and control groups (p < 0.005), and ephedrine requirement was 8% and 60% in the case and control groups respectively (p<0.0005). Conclusions: In high risk patients (renal and cardiopulmonary patients), administration of low volume colloidal solution for the prevention of hypotion in the spinal anesthesia is recommended.    

History and Objectives: Due to high prevalence and increasing number of dialysis patients, and several reports of anxiety among patients, and conflicting recent report, the present study was pe10rmed on patients referred to the Sodeh Dialysis Unit of Imam Hossein Hospital of Islam-Shar in 2000 in order to determine the extent of anxiety - dialysis relationship. Materials and Methods: A cross-sectional study was carried out. All patients were at least receiving one year of dialysis treatment. Control group were selected from healthy volunteers. Age, sex and marital status were matched between control and case groups. The anxiety rate was evaluated by a psychiatric assistant, under the supervision of a psychiatrist, using Hamilton Anxiety Test. Results: The study was conducted on 54 controls and 51 case groups. The anxiety scale in control and case groups were 34±2.4 and 24.9±8.2 respectively. The results in two groups were analyzed by Kruskall- Wallis statistical method, showing that the rate was significantly higher in patients. Dialysis could be of importance in provoking anxiety. Conclusions: Finding the cause of anxiety in dialyzed patients and also determining the effect of shared psychiatric and nephrologic services on cost, course of disease and treatment of patients, deserves more research.      

History and Objectives: Interalesional bleomycin therapy is an effective method for treatment of intractable warts. Diverse concentration of drugs by different methods and protocols are applied and various degree of success rates have been achieved. In the present study, we have used a new technique of bleomycin injection to treat recalcitrant warts by multiple puncture technique (MPT). Materials and Methods: Following local anesthesia with 1% lidocaine on 158 warts in 55 patients with recalcitrant common, palmar, periungual, subungual, plantar and mosaic warts. Bleomycin solution (1mg/mL) was dropped on the surface of the wart and picked into the wart by iizsulin syringe (40 punctures/ 5mm2 surface areas). The treatment was repeated on monthly basis until improvement was observed. However treatment was repeated for miximum of four times. Results: A success rate of 83.5% was achieved ranging from 50% in mosaic warts to 91.8% in common warts which compares with results of other studies. This technique is easily available and well tolerated with minimal or no complication. Conclusions: Due to success rate, availability and minimal complication and relapse, intralesional bleomycin therapy by MPT is an effective useful, safe and generally well tolerated treatment for recalcitrant warts especially periungual, palmar, subungual plantar and mosaic sites.      

History and Objectives: Since sepsis has a high mortality rate in all elderly and handicap population, specially at nursing homes, the present study was performed in order to identify the prevalence of sepsis. Materials and Methods: A descriptive study was done. Blood samples were collected from 124 residents of Kahrizak Nursing House. After identification of isolated bacteria by standard methods, antibiogram tests were performed to determine the sensitivity or resistance of bacteria to common antibiotics. Sex and age of subjects were recorded. Results: of 124 subjects (32.2% male, 67.8% female), 16.2% had sepsis. The isolated bacteria were coagulase negative staphylococci, Staph. aureus, E. coli, Strep. pyrogenes and Klebsiella. The Gram positive bacteria were resistant to fumatidine (77%), ciprofloxacin (75%), cephazoline (74.5%), and sensitive to co-trimoxazol (82%), gentamycin (80%), and amikacin (78.5%). The Gram negative bacteria were resistant to cephazolin (61.5%), cephalothin (52%), and sensitive to co-trimoxazol (95%), tetracycline (88%), fumatidine (79.5%), and gentamycin (79.5%). Conclusions: In the present study, the isolated bacteria werenormalflora, so it should be emphasized the proper personal hygiene such as hand washings to control infections. Antibiogram test is recommended for isolated bacteria.    

Purpose: To report a uveal metastasis from infiltrative ductal carcinoma of breast.Case Report: A 45year old woman with 9year history of left breast ductal carcinoma and Axillary lymph nodes involvement has found soft tissue and right eye uveal metastasis after 5 and 9 years respectively. Conclusion: Every patient with breast carcinoma should have complete eye examination at least every 6 months to find any metastasis at early stages because visual loss could be prevented with suitable treatment.